de Los Reyes Samantha, Dude Annie, Adams Marci, Castille Deshala, Ouyang David W, Plunkett Beth A
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, NorthShore University HealthSystem, University of Chicago, Evanston, Illinois.
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Chicago, Chicago, Illinois.
Am J Perinatol. 2023 Jan;40(2):222-226. doi: 10.1055/s-0041-1728822. Epub 2021 May 4.
The aim of this study was to evaluate whether the risk of perinatal depression is associated with body mass index (BMI) category.
We performed a retrospective cohort study of women who completed an Edinburgh Postnatal Depression Scale (EPDS) questionnaire during the antepartum period at an integrated health system from January 2003 to May 2018. Risk of perinatal depression was defined as a score of ≥10 on the EPDS or an affirmative response to thoughts of self-harm. Risk of perinatal depression was compared by first trimester BMI category, defined as underweight (BMI: <18.5 kg/m), normal weight (BMI: 18.5-24.9 kg/m), overweight (BMI: 25.0-29.9 kg/m), or obese (BMI: ≥30.0 kg/m). Univariable analyses were performed using , Fisher's exact test, analysis of variance, Kruskal-Wallis, and Wilcoxon rank-sum tests as appropriate to evaluate the association between maternal BMI category, demographic and clinical characteristics, and risk of perinatal depression. Logistic multivariable regression models were performed to adjust for potential confounders identified as variables with < 0.10 in univariable analysis.
Our analysis included 3,420 obese women, 3,839 overweight women, 5,949 normal weight women, and 1,203 underweight women. The overall median gestational age at EPDS administration was 27 weeks (interquartile range: 23-29). Overweight and obese women were more likely to be non-Hispanic Black, Hispanic, multiparous, to have public insurance, prepregnancy diabetes, and chronic hypertension as compared with normal or underweight women ( < 0.001). In univariable analysis, the risk of perinatal depression was not significantly different among underweight (10.8%, odds ratio [OR]: 0.86, 95% confidence interval [CI]: 0.79-1.18) or overweight women (12%, OR: 0.96, 95% CI: 0.79-1.18); however, the risk was higher among obese women (14.7%, 95% CI: 1.21-1.55) compared with normal weight women (11.2%). In multivariable analysis, obesity remained associated with an increased risk of perinatal depression (adjusted OR: 1.19, 95% CI: 1.04-1.35).
Obesity is associated with an increased risk of perinatal depression as compared with women of normal weight.
· Maternal obesity is associated with an increased risk of perinatal depression.. · Maternal BMI is associated with increased risk of perinatal depression.. · Maternal obesity is an independent risk factor for perinatal depression..
本研究旨在评估围产期抑郁症风险是否与体重指数（BMI）类别相关。
我们对2003年1月至2018年5月在一家综合医疗系统产前期间完成爱丁堡产后抑郁量表（EPDS）问卷的女性进行了一项回顾性队列研究。围产期抑郁症风险定义为EPDS得分≥10分或对自我伤害想法的肯定回答。根据孕早期BMI类别比较围产期抑郁症风险，BMI类别定义为体重过轻（BMI：<18.5kg/m）、正常体重（BMI：18.5 - 24.9kg/m）、超重（BMI：25.0 - 29.9kg/m）或肥胖（BMI：≥30.0kg/m）。根据情况使用卡方检验、Fisher精确检验、方差分析、Kruskal - Wallis检验和Wilcoxon秩和检验进行单变量分析，以评估母亲BMI类别、人口统计学和临床特征与围产期抑郁症风险之间的关联。进行逻辑多变量回归模型以调整在单变量分析中被确定为P<0.10的变量的潜在混杂因素。
我们的分析包括3420名肥胖女性、3839名超重女性、5949名正常体重女性和1203名体重过轻女性。进行EPDS评估时的总体中位孕周为27周（四分位间距：23 - 29）。与正常体重或体重过轻的女性相比，超重和肥胖女性更可能是非西班牙裔黑人、西班牙裔、经产妇，有公共保险、孕前糖尿病和慢性高血压（P<0.001）。在单变量分析中，体重过轻（10.8%，优势比[OR]：0.86，95%置信区间[CI]：0.79 - 1.18）或超重女性（12%，OR：0.96，95%CI：（0.79 - 1.18））中围产期抑郁症风险无显著差异；然而，与正常体重女性（11.2%）相比，肥胖女性中风险更高（14.7%，95%CI：1.21 - 1.55）。在多变量分析中，肥胖仍然与围产期抑郁症风险增加相关（调整后OR：1.19，95%CI：1.04 - 1.35）。
与正常体重女性相比，肥胖与围产期抑郁症风险增加相关。
· 母亲肥胖与围产期抑郁症风险增加相关。· 母亲BMI与围产期抑郁症风险增加相关。· 母亲肥胖是围产期抑郁症的独立危险因素。
